The Caritas Processes as a Guide Toward Caring Intentions

BWH is honored to be one of only 11 national affiliates of the prestigious, internationally recognized Watson Caring Science Institute. The hospital was named an affiliate in recognition of its deep commitment to caring science and caring practices for staff, patients, families and communities. Caring science honors the profound connection between caring and healing, and BWH nurses and patient care professionals infuse their practice with the principles of caring science every day.

“The Watson theory of human caring resonates with clinical nurses,” said Susan Lee, PhD, RN, senior nurse scientist and Caritas Fellow at BWH. “Jean Watson is one of the only nurse theorists who continues her work at the practice level. Her theory of caring science is not just academic, it’s very practical.”

Through years of research, Jean Watson, PhD, RN, AHN-BC, FAAN, founder and director of the Watson Caring Science Institute and distinguished professor emerita and dean emerita at the University of Colorado’s Denver College of Nursing, developed the 10 Caritas Processes, which are considered essential components of professional nursing practice. “These core conceptual aspects of the human living processes are grounded within the philosophical and ethical foundation of the body of my caring theory work,” wrote Watson in her paper entitled “Watson’s Theory of Human Caring and Subjective Living Experiences: Carative Factors/Caritas Processes as a Disciplinary Guide to the Professional Nursing Practice,” published in the Danish Clinical Nursing Journal in 2006. “Together, the Caritas Processes serve as a guide for professional practice, as well as a disciplinary blueprint for the Science of Care.”

Since Watson’s visit to BWH as the 2013 Karsh Visiting Scholar, four BWH nurses and leaders have become certified Caritas coaches. This program requires a six-month, in-depth educational training program to become knowledgeable in the principles of caring science and to learn to integrate those principles into one’s practice and workplace. “Caritas coaches are dedicated to living and disseminating the Caritas Processes,” said Lee. Jackie Somerville, PhD, RN, FAAN, chief nursing officer and senior vice president of Patient Care Services, along with Suzanne Fernandes, BSN, RN, Patricia Brita-Rossi, MSN, RN, Marjorie Depestre, BSN, RN, Mary Pennington, MSN, RN, and Katherine Fionte, BSN, RN, are certified as Caritas coaches. Additionally, Nick Peterson, MS, RN, and Stephanie Ahmed, DNP, RN, will complete the Caritas Nurse Certification program in April, becoming coaches, and two additional BWH nurses will soon be enrolled in the program through the Watson Institute.

The Caritas Processes give nurses a common language and help remind them of their true focus, which is caring for humanity. “Clinical nurses can become so involved in their day-to-day work that they can lose sight of the importance of caring,” said Lee. “In the eyes of our patients and families, and of the profession, nothing is more important than caring, which is the true essence of nursing.”

In her paper, Watson asks nurses to be more “in tune to the moment” when interacting with patients and to make interactions “more humane, significant and caring.” Lee says the most important actions encouraged by the Caritas Processes are for nurses to be authentically present by maintaining eye contact, to use touch as a way to communicate care and kindness, to listen deeply and to go beyond superficial answers to get to the heart of what is on patients’ minds.

According to Watson, nurses who understand and abide by these principles will provide more meaningful care and successfully form relationships with patients, families, visitors and colleagues. They will able to more effectively and compassionately care for human life.

“At its core, nursing is defined as caring for the human health experience,” said Lee. “The Caritas Processes unite us as nurses and remind us to foster human connection and shared experiences. They honor the actions that BWH nurses do instinctively, every single day.”